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California Health Insurers Reduce Rate Increases to Tune of $48 Million

California Insurance Commissioner Dave Jones (AP Images)
California Insurance Commissioner Dave Jones (AP Images)

Aetna and Wellpoint subsidiary Anthem Blue Cross as well as Blue Shield have agreed to modify their most recent small group health insurance rate increases in California for the third quarter of 2012 for a total savings of $48 million for small employers, Insurance Commissioner Dave Jones recently announced.

By far the largest premium rate increase withdrawal was Anthem Blue Cross’s of 2.5% July 1 premium increase for small-group preferred provider organization products, resulting in a total savings of approximately $25 million for 45,000 of Anthem Blue Cross's small group policyholders, covering approximately 280,000 individuals.

Anthem had raised rates 4.7% on its small group policyholders in the previous 12 months with its earlier rate increases, the California Insurance Department stated.

Blue Shield Life and Health Co. agreed to provide a credit to 58,000 small employers equivalent to reducing its July 1 third quarter rate increase by 1.5%, resulting in savings of approximately $15 million.  As a result of the credit, the effective Blue Shield rate increase will be 1.6%, which is Blue Shield's only small group rate increase for its small employer policyholders in the last 12 months. 

Aetna has agreed to lower its proposed small group rate from 2.6% down to 1.3% for its 9,200 policyholders (covering approximately 69,000 individuals), which results in a savings of approximately $8 million for small employers.

“We worked closely with the California Department of Insurance (CDI) to reach an agreement on rate changes" that were implemented for our Small Group members effective July 1, Aetna said.

We will continue to work with the CDI to ensure that Californians have access to a portfolio of competitively priced products in the marketplace,” Aetna stated.

“We take our commitment to our small business customers seriously and are making every effort to maintain an affordable array of products that provide access to quality health services in a difficult economic environment, our Small Group customers have health plan options with varying levels of benefits and corresponding premiums. We work to meet their demands and needs as they evolve,” Aetna stated.

Under state law, the state Department of Insurance reviews the rates in order to make a determination about whether the proposed rate is unreasonable, but lacks the authority to reject excessive rate increases. Jones has spoken out against his lack of authority here before, and is trying to change this with Assembly Bill 52, which would give this authority, which the commissioner's office already has for auto, home, property and casualty insurance to the Department of Insurance. Small group policies are available to small employers with 2-50 employees.  

Insurers have a history of reducing average increases in California, or delaying them, under Jones. In 2011, Anthem Blue Cross agreed to reduce the average increase to 9.1%, from 9.8%, and to impose the increase July 1, rather than April 1.

Jones insisted early on that large carriers submit proposed individual rate increases to an extra layer of state review, and that they wait at least 60 days after a rate increase takes effect to ask for a new rate increase.

A recent state law, created by California Senate Bill 1163, required a health plan or health insurer to provide an actuarial analysis explaining the need for an increase.

"Lowering health insurance costs for small employers has been and will continue to be a top priority for me," said Insurance Commissioner Dave Jones. "I appreciate Anthem Blue Cross, Blue Shield and Aetna's response to my request that they lower their proposed July 1st rate increases on small employers." 

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Nichole Morford

Nichole Morford
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